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Abstract and Keywords

This chapter focuses on how communication is affected when, in addition to the physician and the patient, there is another individual present during the interaction. Although it is difficult to estimate the frequency with which triadic (three-person) encounters take place, they occur in a variety of medical situations, including pediatric, obstetric, geriatric, and oncology visits, visits in which an interpreter is present, visits in which health-care professional trainees participate, and a myriad of inpatient situations. Although estimates of the frequency of accompaniment to medical visits vary from study to study, we hypothesize that over the next decade there will be many more encounters in which a third person is present. This is likely to occur because of the rapid growth of the aging of the population (where there is frequent accompaniment in geriatric visits), the greater recognition of medical errors (and the potential role that accompanying third parties may play in reducing errors), the increasing size of the immigrant population that will need translating services, and the consumerist approach to health care. Of note, in recent empirical research, we have observed tetradic (four-person) and pentadic (five-person) medical visits. In this chapter, we briefly review the theoretical basis for understanding multiparty medical encounters (i.e., visits in which more than two interactive participants are present) and examine triadic interactions in four clinical areas: pediatric care, oncologic care, encounters with interpreters present, and geriatric care. We also provide an excerpt of a transcript from a visit to explore interactions in which more than three persons are present. An agenda for future research is suggested.

Michele G. Greene is Professor of Public Health, Brooklyn College, City University of New York.

Ronald D. Adelman

Ronald D. Adelman, M.D., is Professor of Clinical Medicine and Co-Chief of the Division of Geriatrics and Gerontology at Cornell University's Weill Medical College and NewYork-Presbyterian Hospital. He is also the Medical Director of the Irving Sherwood Wright Center on Aging and Co-Director of the Cornell Center for Aging Research and Clinical Care.

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